healthcare communication

医疗保健沟通
  • 文章类型: Journal Article
    背景:根据联邦法律,要求英语水平有限的患者接受语言协调的护理,然而,与说英语的患者相比,他们仍然收到不合格的出院指示。我们旨在总结在英语水平有限的人群中为改善出院指导而采取的干预措施。
    方法:我们对来自美国的学术和灰色文献进行了范围审查,使用系统审查的首选报告项目和范围审查指南的荟萃分析方案。我们搜索了PubMed,Embase,和CINAHL用于改善出院沟通的研究。
    结果:在3330项研究中,19项研究符合标准。干预的核心类型包括书面干预,仅教育干预措施,书面和教育干预,音频和视觉干预,以及其他类型的干预措施。即使在相同的核心干预类型中,干预措施的类型有所不同,检查的结果,和结果。
    结论:将满意度作为结果指标进行研究的大多数干预措施显示出改善,而其他结局没有改善或恶化。需要更严格的方法和社区参与,以进一步分析英语水平有限(LEP)患者的出院干预措施。
    BACKGROUND: Limited English proficiency patients are required under federal law to receive language-concordant care, yet they still receive substandard discharge instructions compared to English-speaking patients. We aimed to summarize the interventions carried out to improve discharge instructions in the limited English proficiency population.
    METHODS: We conducted a scoping review of academic and gray literature from the United States using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols for Scoping Reviews guidelines. We searched PubMed, Embase, and CINAHL for studies to improve discharge communication.
    RESULTS: Of the 3330 studies, 19 studies met the criteria. Core types of interventions included written interventions alone, educational interventions alone, written and educational interventions, audio and visual interventions, and other types of interventions. Even among the same core types of interventions, there were differences in types of interventions, outcomes examined, and results.
    CONCLUSIONS: The majority of included interventions that studied satisfaction as an outcome measure showed improvement, while the other outcomes were not improved or worsened. More rigorous methodology and community involvement are necessary to further analyze discharge interventions for patients with limited English proficiency (LEP).
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  • 文章类型: Journal Article
    本文探讨了ChatGPT替代糖尿病教育者的潜力。糖尿病是一种普遍的慢性疾病,需要持续的教育和支持,以有效地管理他们的病情。然而,糖尿病教育者短缺,传统的教育方法在满足患者的个人需求方面存在局限性。ChatGPT是一种人工智能技术,为教育和支持提供个性化和交互式的方法。在这次审查中,我们提供了ChatGPT技术的概述,讨论糖尿病教育者面临的挑战,回顾支持在糖尿病教育中使用ChatGPT的证据,并检查与其使用相关的道德考虑。我们还为ChatGPT在糖尿病教育中的进一步研究和开发以及融入临床实践提供了建议。ChatGPT有可能改善糖尿病患者获得教育和支持的机会,但需要进一步的研究来更好地了解其有效性和局限性。重要的是要确保以道德和公平的方式开发和整合ChatGPT,以最大程度地提高其潜在利益并最大程度地降低潜在风险。
    This review article explores the potential of ChatGPT as a substitute for diabetes educators. Diabetes is a prevalent chronic disease that requires ongoing education and support for patients to effectively manage their condition. However, there is a shortage of diabetes educators, and traditional education methods have limitations in addressing patients\' individual needs. ChatGPT is an artificial intelligence technology that offers a personalized and interactive approach to education and support. In this review, we provide an overview of ChatGPT technology, discuss the challenges facing diabetes educators, review evidence supporting the use of ChatGPT in diabetes education, and examine ethical considerations related to its use. We also provide recommendations for further research and development of ChatGPT in diabetes education and integration into clinical practice. ChatGPT has the potential to improve access to education and support for patients with diabetes, but further research is needed to better understand its effectiveness and limitations. It is important to ensure that ChatGPT is developed and integrated in an ethical and equitable manner to maximize its potential benefits and minimize potential risks.
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  • 文章类型: Journal Article
    由于越来越多地接受实施促进健康的姑息治疗方法,姑息治疗已成为越来越重要的公共卫生问题。为了探索促进这一方法实施的沟通途径,我们进行了一项范围审查,审查了针对患有生命限制性疾病的老年人的护理计划的沟通和制定,社会和社区部门。我们使用范围界定审查方法来绘制有关初级保健和其他部门之间沟通计划的现有文献(社区,健康,和社交)。搜索了五个数据库MEDLINE(OVID),CINAHL(EBSCO),EMBASE(Elsevier),心理信息(EBSCO),还有Scopus.数据库搜索确定了5,289条记录,经过筛选和手工检索,共提取了28篇文章。通过记录确定了三个主要主题:(1)跨部门专业关系的重要性,(2)社区导航员在分享关爱计划中的重要性,(3)并制定全面和多学科的护理计划。研究结果表明,制定高质量的护理计划对医疗保健提供者很重要;使用电子健康记录系统有助于确保所有医疗保健和社区系统都到位,以帮助患者获得更好的社区护理。社区导航员也是确保计划得到适当和有效传达的关键。需要进一步的研究来确定如何为医疗保健系统建立清晰且正确实施的通信系统,以促进社区部门参与实施护理计划。
    Palliative care has become an increasingly important public health issue due to the rising acceptance of implementing a health promoting palliative care approach. To explore communication pathways that would facilitate implementation of this approach, we conducted a scoping review examining communication and enactment of care plans for older adults with life-limiting illnesses across health, social and community sectors. We used a scoping review methodology to map the current literature on communication plans between primary care and other sectors (community, health, and social). Five databases were searched MEDLINE (ovid), CINAHL (EBSCO), EMBASE (Elsevier), PsychInfo (EBSCO), and Scopus. The database search identified 5,289 records, after screening and hand-searching a total of 28 articles were extracted. Three major themes were determined through the records: (1) the importance of professional relationships across sectors, (2) the importance of community navigators in sharing the care plan, and (3) and creating comprehensive and multidisciplinary care plans. Findings suggested that enacting quality care plans is important to healthcare providers; the use of an electronic health records system can be useful in ensuring that all healthcare and community systems are in place to aid patients for better community-based care. Community navigators were also key to ensure that plans are communicated properly and efficiently. Further research is needed to determine how having a clear and properly implemented communication system for a healthcare system could facilitate community sector involvement in implementing care plans.
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  • 文章类型: Journal Article
    OBJECTIVE: Systematically review parental perceptions of shared decision-making (SDM) in neonatology, identifying barriers and facilitators to implementation.
    METHODS: Electronic database (Medline, PsycINFO, CINAHL and Scopus) and follow-up searches were conducted to identify qualitative studies. Data were extracted, thematically analysed and synthesised.
    RESULTS: Searches yielded 2445 papers, of which 25 were included. Thematic analysis identified six key themes. Key barriers included emotional crises experienced in the NICU setting, lack of medical information provided to parents to inform decision-making, inadequate communication of information, poor relationships with caregivers, lack of continuity in care, and perceived power imbalances between HCPs and parents. Key facilitators included clear, honest and compassionate communication of medical information, caring and empathetic caregivers, continuity in care, and tailored approaches that reflected parent\'s desired level of involvement.
    CONCLUSIONS: The highly specialised environment, and the emotional crises experienced by parents impact significantly on their perceived capacity to engage in surrogate decision-making.
    CONCLUSIONS: Complex and multi-factorial interventions that address the training needs of HCPs, and the emotional, informational and decision support needs of parents are needed. SDM skills training, improved information delivery, and integrated emotional and decisional support could help parents to become more involved in SDM for their infant.
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  • 文章类型: Journal Article
    深入了解支持或阻碍自治的支持性协商的环境因素和机制,以及此类协商的结果。
    我们根据RAMESES指南使用现实主义综合程序进行了系统评价。在PubMed中进行了搜索,Embase,PsycINFO和Cinahl从成立到2019年3月使用搜索词:\'自治\'和\'支持\'和\'咨询\'或\'沟通\'和\'干预\'。审查过程包括论文选择,质量评估,数据提取的全文阅读由两名研究人员独立进行。
    在2792篇文章中,18符合我们的纳入标准。影响自治支持性咨询的上下文因素是:工作组织和专业人员的态度。AS的总体支持机制是建立关系。此外,决策过程的每个阶段似乎都需要支持机制来满足患者的特定心理需求。AS的结果是更高水平的患者健康。
    自治支持性咨询在各种环境下工作,加上产生有利结果的机制,建立关系,花时间和探索病人的需求似乎是最重要的。
    我们的审查结果有助于专业人士反思他们的自主性支持性咨询技能,这可以改善他们的自主性支持行为。
    Gaining insight into contextual factors and mechanisms supporting or hindering autonomy supportive consultation and into outcomes of such consultations.
    We conducted a systematic review using the realist synthesis procedure according to RAMESES guideline. A search was performed in PubMed, Embase, PsycINFO and Cinahl from inception to March 2019 using the search terms: \'autonomy\' AND \'support\' AND \'consultation\' OR \'communication\' AND \'intervention\'. The review process including paper selection, quality assessment, full text reading for data-extraction was conducted by two researchers independently.
    Of 2792 articles, 18 met our inclusion criteria. Contextual factors influencing an autonomy supportive consultation were: work organization and the attitude of professionals. An overarching supporting mechanism for AS was relationship building. In addition, each phase of the decision-making process seems to need supporting mechanisms fulfilling patients \'specific psychological needs in that phase. The outcome of AS is higher levels of patient well-being.
    Autonomy supportive consultation works under various contexts coupled with mechanisms that give rise to favourable-outcomes, of which relationship building, taking time and exploring patients\' needs seem the most important.
    The results of our review facilitate professionals to reflect on their autonomy supportive consultation skills, which could improve their autonomy supportive behaviour.
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